Treatment of Distal Radioulnar Joint Injuries Associated with a Distal Radius Fracture

Choi,  Ki Bum; Huh,  Sung Woo; Kim,  Seong Eun; Lee,  Jung Woo; Song,  Seok Whan; Rhee,  Seung Koo

doi:2012.17.4.147

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Arch Hand Microsurg > Volume 17(4); 2012 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2012;17(4):147-152.
Published online December 30, 2012.
DOI: https://doi.org/10.12790/jkssh.2012.17.4.147

Treatment of Distal Radioulnar Joint Injuries Associated with a Distal Radius Fracture

Ki Bum Choi, Sung Woo Huh, Seong Eun Kim, Jung Woo Lee, Seok Whan Song, Seung Koo Rhee

Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. skrhee@catholic.ac.kr

Received: 10 May 2012 • Revised: 14 September 2012 • Accepted: 21 September 2012

Abstract

Purpose
Distal radius fractures involving distal radioulnar joint (DRUJ) are common. After the fracture treatment, pain on the ulnar side of wrist, limitation of forearm rotation and instabilities can be remained. The purpose of this study was to address the importance of anatomical reduction for DRUJ injuries.

Methods
Of 115 cases with a distal radius fracture involving DRUJ, 61 cases involving sigmoid notch of the radius or having a ulnar styloid process base fracture were evaluated. At an average of six months follow-up, their final outcomes were investigated using radiologic findings, functional disabilities of the arm, shoulder and hand (DASH) and visual analogue scale (VAS) pain scores and wrist motion of pronation/supination.

Results
Satisfied radiologic reduction rate was 73.8%(45/61) in average, which was most favorable in external fixator group (82.4%, 28/34). The mean functional DASH score was 29.0 points and mean VAS for pain was 5.0. The mean range of wrist motions for pronation/supination was 59.5degrees/55.7degrees.

Conclusion
Distal radius fractures involving DRUJ should be classified into the basic categories of unstable distal radius fracture, and immediate anatomical reduction is needed by operative treatment to avoid painful forearm rotation.

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